The purpose of this review was to systematically search and critically analyse the literature pertaining to behavioural outcomes of exercise interventions for individuals with autism spectrum disorder aged ⩽16 years. This systematic review employed a comprehensive peer-reviewed search strategy, two-stage screening process and rigorous critical appraisal, which resulted in the inclusion of 13 studies. Results demonstrated that exercise interventions consisting individually of jogging, horseback riding, martial arts, swimming or yoga/dance can result in improvements to numerous behavioural outcomes including stereotypic behaviours, social-emotional functioning, cognition and attention. Horseback riding and martial arts interventions may produce the greatest results with moderate to large effect sizes, respectively. Future research with well-controlled designs, standardized assessments, larger sample sizes and longitudinal follow-ups is necessary, in addition to a greater focus on early childhood (aged 0-5 years) and adolescence (aged 12-16 years), to better understand the extent of the behavioural benefits that exercise may provide these populations.

Biological aging is associated with progressive damage accumulation, loss of organ reserves, and systemic inflammation ('inflammaging'), which predispose for a wide spectrum of chronic diseases, including several types of cancer. In contrast, aerobic exercise training (AET) reduces inflammation, lowers all-cause mortality, and enhances both health and lifespan. In this study, we examined the benefits of early-onset, lifelong AET on predictors of health, inflammation, and cancer incidence in a naturally aging mouse model (C57BL/J6). Lifelong, voluntary wheel-running (O-AET; 26-month-old) prevented age-related declines in aerobic fitness and motor coordination vs. age-matched, sedentary controls (O-SED). AET also provided partial protection against sarcopenia, dynapenia, testicular atrophy, and overall organ pathology, hence augmenting the ‘physiologic reserve’ of lifelong runners. Systemic inflammation, as evidenced by a chronic elevation in 17 of 18 pro- and anti-inflammatory cytokines and chemokines (P < 0.05 O-SED vs. 2-month-old Y-CON), was potently mitigated by lifelong AET (P < 0.05 O-AET vs. O-SED), including master regulators of the cytokine cascade and cancer progression (IL-1β, TNF-α, and IL-6). In addition, circulating SPARC, previously known to be upregulated in metabolic disease, was elevated in old, sedentary mice, but was normalized to young control levels in lifelong runners. Remarkably, malignant tumours were also completely absent in the O-AET group, whereas they were present in the brain (pituitary), liver, spleen, and intestines of sedentary mice. Collectively, our results indicate that early-onset, lifelong running dampens inflammaging, protects against multiple cancer types, and extends healthspan of naturally-aged mice.

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Bariatric patients are difficult to assess clinically for signs of postoperative complication. Diagnostic laparoscopy (DL) is used to investigate patients suspicious for complications such as anastomotic leak (AL) and intra-abdominal hemorrhage (IH). Most bariatric surgeons use DL in the presence of sustained tachycardia; however, the rate of this procedure and its clinical value have not been sufficiently investigated.A retrospective review of patients undergoing bariatric surgery from January 2010 to December 2011 was performed. Data from 4 collaborative bariatric centres of excellence were included in this analysis. From among all elective bariatric procedures, cases that required early reoperation were selected for further evaluation.A total of 1001 elective bariatric procedures were identified. Of these, 952 (95%) were primary bariatric procedures, including 866 (91%) Roux-en-Y gastric bypasses and 86 (9%) sleeve gastrectomies. The remaining 48 cases represented revisional proced ures. Of these, 11 patients (1.1%) returned to the operating room within 72 hours for DL: 64% were primary cases (n = 7) and 36% revisional cases (n = 4). Intraoperative findings included AL (45%, n = 5), IH (27%, n = 3), no pathology identified (18%, n = 2) and small bowel obstruction (9%, n = 1). Of the 9 patients with complications, all were tachycardic (heart rate > 100 beats/min), and 4 of the 5 patients with AL were febrile (t > 37.5). There were no reported adverse events directly related to the use of DL.Diagnostic laparoscopy is a useful and safe option for both the diagnosis and treatment of suspected complications after bariatric surgery. The majority of patients returning to operating room had significant findings, and all were treated laparoscopically. Persistent postoperative tachycardia or fever were highly predictive of positive findings during DL. An emphasis on early decisionmaking and expeditious return to the operating room for laparoscopy should be the standard for bariatric patients on clinical suspicion of a postoperative complication. 4Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding. A